<form action="/hotel/dobooking/" method="post">
<div id="mid-content">		  
	<!-- Mid Content Left aria start ............. -->			  
	<div class="mid-cont-left">
	<!-- Hot Tours start -->
		<div class="quarry-6">
			<span class="quarry-6-top"></span>
			<div class="quarry-6-mid" align="center">
				<h1 class="h1-long-3">Booking Request Form</h1>			
				<table border="1" width="95%" cellpadding="1" cellpadding="2">
					<tr>
						<td colspan="3">You have selected : <?php echo $this->hotel_arr['hotel_title']; ?> - <?php echo $this->hotel_arr['city_name']; ?></td>
					</tr>
					<tr>
						<td>Check-in</td>
						<td>Check-out</td>
						<td>No. of nights</td>
					</tr>
					<tr>
						<td>
							<select name="CheckInD" id="CheckInD">
								<option selected="selected">Date</option>
								<?php
									for ($i = 1; $i <= 31; $i++) {
										if($i <= 9) {
											$i = "0" . $i;
										}
								?>
									<option value="<?php echo $i; ?>"><?php echo $i; ?></option>
								<?php
									}
								?>
							</select>&nbsp;
							<select name="CheckInM" id="CheckInM">
								<option value="" selected="selected">Month</option>
								<option value="01">January</option>
								<option value="02">February</option>
								<option value="03">March</option>
								<option value="04">April</option>
								<option value="05">May</option>
								<option value="06">June</option>
								<option value="07">July</option>
								<option value="08">August</option>
								<option value="09">September</option>
								<option value="10">October</option>
								<option value="11">November</option>
								<option value="12">December</option>
							</select>&nbsp;
							<select name="CheckInY" id="CheckInY">
								<option selected="selected">Year</option>
								<?php
									for ($j = 2011; $j<= 2013; $j++) {										
								?>
									<option value="<?php echo $j; ?>"><?php echo $j; ?></option>
								<?php
									}
								?>
							</select>
						</td>
						<td>
							<select name="CheckOutD" id="CheckOutD">
								<option selected="selected">Date</option>
								<?php
									for ($i = 1; $i <= 31; $i++) {
										if($i <= 9) {
											$i = "0" . $i;
										}
								?>
									<option value="<?php echo $i; ?>"><?php echo $i; ?></option>
								<?php
									}
								?>
							</select>&nbsp;
							<select name="CheckOutM" id="CheckOutM">
								<option value="" selected="selected">Month</option>
								<option value="01">January</option>
								<option value="02">February</option>
								<option value="03">March</option>
								<option value="04">April</option>
								<option value="05">May</option>
								<option value="06">June</option>
								<option value="07">July</option>
								<option value="08">August</option>
								<option value="09">September</option>
								<option value="10">October</option>
								<option value="11">November</option>
								<option value="12">December</option>
							</select>&nbsp;
							<select name="CheckOutY" id="CheckOutY">
								<option selected="selected">Year</option>
								<?php
									for ($j = 2011; $j<= 2013; $j++) {										
								?>
									<option value="<?php echo $j; ?>"><?php echo $j; ?></option>
								<?php
									}
								?>
							</select></td>

									<td><input name="noofnights" id="noofnights" size="10" value="" type="text"></td>
								</tr>
								<tr>
									<td colspan="3">&nbsp;</td>
								</tr>
								<tr>
									<td class="a7"><b>Room Category</b>: <font color="#ff0000">*</font></td>

									<td class="a7"><b>Room Type</b>: <font color="#ff0000">*</font></td>
									<td class="a7"><b>Rooms</b>: <font color="#ff0000">*</font></td>
								</tr>

								<tr>
									<td colspan="3">&nbsp;</td>

								</tr>

								<tr>
									<td>	
										<select name="cmbRoomCat" id="cmbRoomCat" onchange="getRoomTypes()">
										<option value="">Room Category</option>
											<?php 
												foreach ($this->room_cat_arr as $room_cat_entry) :
											?>
												<option value="<?php echo $room_cat_entry['roomcat_id']; ?>"><?php echo $room_cat_entry['roomcat_type']; ?></option>
											<?php
												endforeach;
											?>										
										</select>
										</td>
										<td>
											<select name="cmbRoomType" id="cmbRoomType">
												<option value="" selected="selected">Room Types</option>
											</select>
										</td>
										<td><select name="rooms" id="rooms">
										<option value="" selected="selected">Rooms</option>
										<option value="1">1 room</option>
										<option value="2">2 rooms</option>
										<option value="3">3 rooms</option>

										<option value="4">4 rooms</option>
										<option value="5">5 rooms</option>
										<option value="6">6 rooms</option>
										<option value="7">7 rooms</option>
										<option value="8">8 rooms</option>
										<option value="9">9 rooms</option>

										<option value="10">10 rooms</option>
										<option value="11">11 rooms</option>
										<option value="12">12 rooms</option>
										<option value="13">13 rooms</option>
										<option value="14">14 rooms</option>
										<option value="15">15 rooms</option>

										</select>&nbsp;<a href="javascript:ratepoppup('TL00055')"><img src="http://www.srilanka.com/images/hb_ratesbut.gif" alt="Rates" title="Rates" border="0"></a> </td>	
									</tr>
									<tr>
										<td colspan="3">&nbsp;</td>
									</tr>

									<tr>
										<td class="a7" valign="top"><b>Adult</b><font color="#ff0000">*</font><br><br><select name="adult" id="adult">

										<option value="">0</option>
										<?php
											for ($j = 1; $j <= 30; $j++) {
										?>
											<option value="<?php echo $j; ?>"><?php echo $j; ?></option>
										<?php
											}
										?>
											
										
									</select></td>

										 <td class="a7" valign="top"><b>Children</b><br><br> 
										<select name="children" id="children">
										<option value="">0</option>
										<?php
											for ($j = 1; $j <= 10; $j++) {
										?>
											<option value="<?php echo $j; ?>"><?php echo $j; ?></option>
										<?php
											}
										?>	
								</select>

										</td>
										<td class="a7">
											</td>
										</tr>

							
						
						
										<tr>
											<td colspan="3">&nbsp;</td>
										</tr>

										<tr>
											<td colspan="3" class="a7"><input name="additional_info_option" id="additional_info_option" value="1" onclick="return showAdditionalInfo(this);" type="checkbox"><b> Do you need an additional room?</b></td>

										</tr>
										<tr>
											<td colspan="3" class="a7"><input name="transfer_option" id="transfer_option" value="1" onclick="return showTransferInfo(this);" type="checkbox"><b> Do you need an Airport Transfer?</b></td>
										</tr>
										
								<tr>
									<td colspan="3">&nbsp;</td>
								</tr>
								<tr>
									<td colspan="3">Contact Details</td>
								</tr>
								<tr>
									<td>Your Name</td>
									<td colspan="2"><input type="text" name="txtName" id="txtName" value="" /></td>
								</tr>
								<tr>
									<td>Email Address</td>
									<td colspan="2"><input type="text" name="txtEmail" id="txtEmail" value="" /></td>
								</tr>
								<tr>
									<td>Contact Number</td>
									<td colspan="2"><input type="text" name="txtContact" id="txtContact" value="" /></td>
								</tr>
								<tr>
									<td>Country</td>
									<td colspan="2">
										<select name="hotel_country" id="cmbCountry" onchange="getCityByCountry()">
											<option value="">Country</option>
											<?php 
												foreach ($this->country_arr as $country) :
											?>
												<option value="<?php echo $country['country_id']; ?>"><?php echo $country['country_name']; ?></option>
											<?php 
												endforeach;
											?>
										</select>
									</td>
								</tr>
								<tr>
									<td>City</td>
									<td colspan="2">
										<select name="cmbCity" id="cmbCity">
											<option value="">City</option>											
										</select>
									</td>
								</tr>
								<tr>
									<td>&nbsp;</td>
									<td colspan="2"><input type="button" name="btnSendBooking" id="btnSendBooking" value="Send Booking Request" onclick="sendBookingRequest()" /></td>
								</tr>
				</table>
			</div>
		</div>
	</div>
</div>
</form>